Healthcare Provider Details

I. General information

NPI: 1194337618
Provider Name (Legal Business Name): JULIA SYBRANT PHARMD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2020
Last Update Date: 08/17/2020
Certification Date: 08/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 MILLER TRUNK HWY
DULUTH MN
55811-5633
US

IV. Provider business mailing address

1201 MILLER TRUNK HWY
DULUTH MN
55811-5633
US

V. Phone/Fax

Practice location:
  • Phone: 218-727-8157
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number124368
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: